Nursing staff are frequently unable to take their breaks, are having to stay behind at the end of work and are being given “barbaric” rotas with back-to-back day and night shifts, which is putting both them and their patients at risk, it has been warned.
Members of the Royal College of Nursing speaking at the union’s annual congress in Liverpool today said employers were largely to blame, because these practices were occurring due to their failure to deal with service pressures and staffing gaps.
“We have regular late-early-late-early shifts in succession…you don’t know whether you are coming or going”
They said that in some cases the practice amounted to a breach of laws by employers under the UK’s Working Time Regulations, which include requirments such as a 20-minute break for every six hours of work and an 11-hour rest period between long shifts.
Others also suggested some nurses were opting to work for longer – sometimes more than 60 hours per week – to increase their wages, because nursing salaries were so low.
Another nurse highlighted that in the independent sector staff often had their break time deducted from their wages, regardless of whether they took them or not.
One nurse warned that the situation could worsen following Brexit because the UK laws protecting rest breaks had come from European legislation, which meant they could be lost.
Meanwhile, concerns were raised that student nurses were working long hours on clinical placements, alongside paid jobs, which was affecting their learning.
“Employers should be held to account for their employees being unable to take adequate rest breaks”
In addition, during a separate session this week at the conference, a nurse from an NHS trust in Oxfordshire described “barbaric” shift patterns at her organisation, which was causing burnout among staff.
“We have regular late-early-late-early shifts in succession. And by the time you get to that fourth day you don’t know whether you are coming or going,” she said. “We regularly finish late on the late shift.
“The employer thinks they can get away with it by saying ’you need to go home’ while, as nurses, we all know if you’ve got write-ups to do or are still in handover or, if you’re liaising with doctors because you’ve got problems with your patients, you don’t go home because you are dealing with the situation,” she added.
During a congress debate on the issue of working patterns today, Denise McLaughlin – chair of the RCN’s UK safety representatives’ committee which put forward the issue – highlighted a recent RCN survey which found many nurses has been on shifts “without even being able to take a break to use the toilets”.
“These nurses were working multiple part-time contracts. This is a symptom…of low pay”
“These nurses were working multiple part-time contracts and had a zero hour contract,” said Garry Campbell.
“This is a symptom of a disease. The symptom of low pay, staff having to take multiple contracts, staff needing this money to make ends meet,” he added.
Marie Rogers, from the RCN’s Northern Region, said that when she previously worked as a team leader of a district nursing team she would regularly leave two to three hours late “just so I could get through my daily visits and carry out my management duties”.
She said she was told this was bad time management by colleagues, but she told today’s conference that “no, this was bad staffing levels”.
“We should not be made to feel bad for taking time off in lieu, nor should we feel bad for taking any unpaid lunchtime breaks, or leaving on time,” she said.
“We need to make sure our [NHS] trusts acknowledge unpaid work..but we must [also] stop being martyrs”
“We need to make sure our [NHS] trusts acknowledge the unpaid work we do but likewise we must take some responsibility for our actions and stop being martyrs,” added Ms Rogers.
Later, a healthcare assistant who had in the past worked patterns of consecutive long shifts warned nurses in the same position that this could put their registration at risk.
“At my previous employer, a shift pattern that found myself on quite often was going from a late to an early, or a late onto a long day of 14 hours, then back onto an early,” said Leslie Green.
“Some people have said we shouldn’t have days and nights in the same week and we shouldn’t do a run of long shifts – but I choose to do that”
“I was doing that as an HCA and I was absolutely washed out and exhausted. I’m not making drug calculations as nurses are. Surely that means your employer is putting your PIN, your livelihood, at risk,” he told the conference.
However, one nurse highlighted that it suited some staff to work long shifts back-to-back.
Helen O’Boyle, from the RCN’s North Central Inner London branch, said: “We’ve all got a choice. Some people have said we shouldn’t have days and nights in the same week and we shouldn’t do a run of long shifts – but I choose to do that.”
Following the debate, the RCN congress overwhelmingly passed a motion calling on the RCN council to “challenge vigorously employers who fail in their duty to comply with working time regulations”.
Resolution submitted by the RCN UK Safety Reps committee
That this meeting of RCN Congress asks Council to challenge vigorously employers who fail in their duty to comply with working time regulations.